CSAC Bulletin Article

Health and Human Services Legislation Outcomes from Appropriations Suspense Hearing

May 25, 2023

Last Thursday, the Senate and Assembly Appropriations Committees convened their suspense file hearings for bills introduced in their house of origin. During these hearings, certain bills may be held under submission and do not advance forward for a Floor vote. Some bills are passed out of committee, some bills are held, and others are turned into two-year bills. As the deadline to pass bills in their house of introduction approaches, the CSAC Health and Human Services policy unit wanted to provide an update on key bills of interest to counties.

AB 33 (Bains) – Passed out of Appropriations.

This measure would establish the Fentanyl Addiction and Overdose Prevention Task Force to undertake various duties relating to the assessment of the nature and extent of fentanyl abuse in California and the evaluation of approaches to increase public awareness of fentanyl abuse. Representatives from a local health department, the County Behavioral Health Directors Association, and the County Health Executives Association of California will serve on this Task Force to provide important local perspectives to enhance the development of recommendations to strengthen state and local efforts to prevent fentanyl abuse, protect and assist persons who misuse fentanyl or other illicit substances that may contain fentanyl, and develop policy recommendations on the implementation of evidence-based practices to reduce fentanyl overdoses. Amendments taken out of Assembly Appropriations make the bill’s provisions subject to an appropriation. CSAC is in support of this measure.

AB 262 (Holden) – Passed out of Appropriations.

This measure would direct the California Department of Social Services (CDSS) to establish a statewide workgroup to develop recommendations and a report to the Legislature pertaining to child safety at children’s camps. Previous legislative proposals relating to children’s camps have inappropriately assigned responsibility to local health departments to regulate child supervision and safety. However, AB 262 instead directs CDSS to lead a stakeholder process to identify entities with the appropriate expertise to oversee these camps’ operations and ensure children’s safety. CSAC joins a coalition in support of AB 262.

AB 525 (Ting) – Held in Appropriations.

This measure, which CSAC supported, would have created a supplemental housing payment for nonminor dependent foster youth placed in supervised independent living placements. Transition-age foster youth and former foster youth are significantly more likely to experience homelessness and housing instability than those who have not entered the foster care system. AB 525 aligned with the goals and policy recommendations found in AT HOME, the county comprehensive plan to address homelessness. Although AB 525 will not be moving forward this year, there is a companion stakeholder budget request.

AB 799 (Luz Rivas) – Passed out of Appropriations.

This measure would aim to create an ongoing state-funded program to meet identified goals for the existing Homeless Housing, Assistance and Prevention (HHAP) program. The bill would modify some of the HHAP allocations to emphasize performance and collaboration, require the submission of regional homeless action plans,  and require participating entities to set specific output goals. CSAC has not taken an official position on this bill but continues to engage with the author and sponsors of the measure in alignment with the CSAC AT HOME Plan.

AB 1057 (Weber) – Passed out of Appropriations.

This measure seeks to give additional flexibility to local health jurisdictions to administer more Home Visiting Programs that address the unique needs of their communities and provide support to families who need it most. AB 1057 will accomplish three objectives: it will allow local health departments the flexibility to use any other federally approved home visiting model. It will also permit local health departments the opportunity to supplement home visiting with mental health supports and training. Lastly, local health jurisdictions will have the opportunity to submit an alternative public health nursing model that prioritizes the unique needs of individuals in that jurisdiction. CSAC joins the Urban Counties of California (UCC) and the Rural County Representatives of California (RCRC) in support of AB 1057.

AB 1168 (Bennett) – Passed out of Appropriations.

This measure, which is sponsored by Cal Cities, seeks to overturn case law record that has repeatedly affirmed county responsibility for the administration of emergency medical services and would ultimately result in fragmented and inequitable delivery of emergency medical services. Under the measure, cities and fire districts could opt to back out of longstanding agreements with counties; counties would then be forced to open up already complex ambulance contracting processes while scrambling to provide continued services to impacted residents. CSAC joins the County Health Executives Association of California (CHEAC), the Health Officers Association of California (HOAC), RCRC, and UCC in opposition to AB 1168.

AB 1672 (Haney) – Passed out of Appropriations.

This bill would shift the employer of record for the In-Home Supportive Services (IHSS) program from counties to the state for the purposes of collective bargaining. Specifically, the state would be charged with negotiating with a recognized employee organization regarding the wages, health benefits, and other benefits for IHSS providers. In partnership with the County Welfare Directors Association of California (CWDA) and the California Association of Public Authorities (CAPA), CSAC has engaged with the sponsors, SEIU and UDW, and author’s office regarding this bill. While not yet taking a position on AB 1672, we have provided specific feedback on certain provisions of the bill and overarching comments focused on three key aspects that would be needed if bargaining were to be transferred to the state:

(1)          The state must be responsible for the full cost of any negotiated wage and benefit increases agreed to in state bargaining and must fully fund any negotiated new mandates on counties and public authorities;

(2)          The key functions and services that public authorities provide outside of collective bargaining must be preserved and strengthened; and

(3)          Counties and public authorities should be involved in some manner and have input on any changes that relate to the work required of counties and public authorities.

SB 43 (Eggman) – Passed out of Appropriations.

This measure seeks to broaden the definition of “gravely disabled” for the purposes of the Lanterman-Petris-Short (LPS) Act, which provides for the involuntary detention and/or conservatorship and treatment of individuals who have been determined to be, as the result of a mental health disorder or impairment by chronic alcoholism, unable to provide for their basic personal needs for food, clothing, or shelter. As currently drafted, the measure does not provide resources to counties to implement this expanded caseload. CSAC has not taken an official position on SB 43 and will continue to engage on this measure and advocate for additional, ongoing funding to support the activities and supply of placement options for the existing and new clients.

SB 282 (Eggman) – Passed out of Appropriations.

This measure would allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to receive Medi-Cal reimbursement for up to two visits that take place on the same day. Under the current reimbursement system, if a patient visits their co-located medical provider and mental health provider on the same day, the FQHC or RHC will only receive a payment for one of the providers. This process results in providers having to schedule mental health appointments on subsequent days, or else clinics must take on an increased financial burden. An additional burden is also placed on patients, who must arrange transportation, time off work, and caregiving for single appointments on different days. SB 282 will increase access to care for some of California’s most vulnerable residents and ensure FQHCs and RHCs are reimbursed for the services these residents need when they need them most. CSAC joins RCRC and UCC in support of SB 282.

SB 318 (Ochoa Bogh) – Passed out of Appropriations.

This measure would, upon appropriation, establish the 211 Support Services Grant Program, which would support, scale, and innovate 211 services across California. Specifically, SB 318 would strengthen and enhance 211 services by supporting core operations and capacity, improve data sharing to health and government partners, and ensure 211 availability across rural counties. CSAC joins UCC and RCRC in support of SB 318.

SB 551 (Portantino) – Passed out of Appropriations.

This measure would impose additional requirements on the composition of community mental health boards, which are already subject to various membership requirements. A previous version of this bill, which CSAC opposed, would have diverted Mental Health Services Act funds for specified purposes. Although the amendments to the bill removed CSAC’s opposition, CSAC joins UCC and RCRC in a position of concerns with the bill, as the additional requirements will present potential challenges for community mental health boards to fill and maintain these memberships.

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